What are the responsibilities and job description for the Managed Care Contracting Manager position at US Oncology Network-wide Career Opportunities?
Virginia Oncology Associates, the largest group of medical professionals in Hampton Roads and Northeast North Carolina devoted exclusively to cancer care and blood disorders, has an exciting opportunity for a Managed Care Contracting Manager to support the practice from our Business Office in Norfolk.
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Responsibilities
- Assists Cellular Therapy Team in evaluating and developing patient insurance agreements related to contract language, reimbursement rates and other proposal components.
- Supports the Cellular Therapy Team in assisting with insurance authorization issues related to Transplant and CAR-T therapy procedures.
- Develops and maintains policies and processes related to cell therapy authorization, agreement negation and insurance requirements.
- Communicates and contracts with insurance providers related to negotiation of managed care contracts within the practice.
- Works with outside vendors to assist as needed with insurance denial support.
- Monitors payments for cell therapy post procedure to verify payment received according to agreement and works with appropriate business office personnel to address any concerns identified.
- Tracks vendor charges against services provided for cell therapy procedures performed.
- Liaison with the RBO to share patient or insurance specific contract agreements to ensure correct billing protocol in place per agreement.
- Provide the RBO with product reimbursement information and notify of new therapies for VOA to allow for set-up time in Athena for prompt billing and denial support.
- Assists finance team with developing and maintaining monthly analytics to support monthly financial statements specific to cellular therapy product line.
Qualifications
- High School Diploma required.
- Bachelor's degree preferred, preferably in Healthcare Administration, Business Administration, or Insurance and Risk Management.
- Minimum 7 years required of managed care, contract negotiations, or end to end revenue cycle experience
- Proficiency with Microsoft Office (Excel, Word, PowerPoint).
- Strong verbal and written communication skills.
- Strong analytical skills.
- Must be willing to travel between sites as needed.
The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.
